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Miscellanea
Images in paediatrics
Clavicular swelling—classic presentation of chronic non-bacterial osteomyelitis
  1. M Amjad Khan1,
  2. Nigel J Osborne2,
  3. Rahul Anaspure3,
  4. A V Ramanan1
  1. 1Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
  2. 2Department of Paediatrics, Royal Exeter and Devon NHS Foundation Trust, Exeter, UK
  3. 3Department of Radiology, Royal Exeter and Devon NHS Foundation Trust, Exeter, UK
  1. Correspondence to Dr A V Ramanan, Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8AE, UK; avramanan{at}hotmail.com

https://doi.org/10.1136/archdischild-2012-303187

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    An 11-year-old boy presented with a 12 month history of progressive right clavicular swelling (figure 1). Clinical examination raised a differential diagnosis to include osteomyelitis and malignancy.

    Figure 1

    Photograph showing swelling of medial aspect of right clavicle.

    Radiographic examination showed marked enlargement of the medial half of the clavicle (figure 2), with layered periosteal reaction. CT and MRI of the lesion showed lytic, destructive, expansile bone lesion, indicative of aggressive nature (figure 3). Bone …

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    Footnotes

    • Contributors RA and MAK prepared the manuscript. NJO and AR contributed to portions of the manuscript and reviewed the whole manuscript. RA is the guarantor of the manuscript.

    • Funding None.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.